Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia
Abstract Background Data regarding the clinical effects of bacteremia on severe community-acquired pneumonia (CAP) are limited. Thus, we investigated clinical characteristics and outcomes of severe CAP patients with bacteremia compared with those of subjects without bacteremia. In addition, we evalu...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08887-5 |
| _version_ | 1797377133940572160 |
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| author | Tae Wan Kim Se-Uk Lee Boram Park Kyeongman Jeon Sunghoon Park Gee Young Suh Dong Kyu Oh Soo Yeon Lee Mi Hyeon Park Haein Lee Chae-man Lim Ryoung-Eun Ko Korean Sepsis Alliance (KSA) investigators |
| author_facet | Tae Wan Kim Se-Uk Lee Boram Park Kyeongman Jeon Sunghoon Park Gee Young Suh Dong Kyu Oh Soo Yeon Lee Mi Hyeon Park Haein Lee Chae-man Lim Ryoung-Eun Ko Korean Sepsis Alliance (KSA) investigators |
| author_sort | Tae Wan Kim |
| collection | DOAJ |
| description | Abstract Background Data regarding the clinical effects of bacteremia on severe community-acquired pneumonia (CAP) are limited. Thus, we investigated clinical characteristics and outcomes of severe CAP patients with bacteremia compared with those of subjects without bacteremia. In addition, we evaluated clinical factors associated with bacteremia at the time of sepsis awareness. Methods We enrolled sepsis patients diagnosed with CAP at emergency departments (EDs) from an ongoing nationwide multicenter observational registry, the Korean Sepsis Alliance, between September 2019 and December 2020. For evaluation of clinical factors associated with bacteremia, we divided eligible patients into bacteremia and non-bacteremia groups, and logistic regression analysis was performed using the clinical characteristics at the time of sepsis awareness. Result During the study period, 1,510 (47.9%) sepsis patients were caused by CAP, and bacteremia was identified in 212 (14.0%) patients. Septic shock occurred more frequently in the bacteremia group than in the non-bacteremia group (27.4% vs. 14.8%; p < 0.001). In multivariable analysis, hematologic malignancies and septic shock were associated with an increased risk of bacteremia. However, chronic lung disease was associated with a decreased risk of bacteremia. Hospital mortality was significantly higher in the bacteremia group than in the non-bacteremia group (27.3% vs. 40.6%, p < 0.001). The most prevalent pathogen in blood culture was Klebsiella pneumoniae followed by Escherichia coli in gram-negative pathogens. Conclusion The incidence of bacteremia in severe CAP was low at 14.0%, but the occurrence of bacteremia was associated with increased hospital mortality. In severe CAP, hematologic malignancies and septic shock were associated with an increased risk of bacteremia. |
| first_indexed | 2024-03-08T19:49:21Z |
| format | Article |
| id | doaj.art-6f37c1d44b404b15b17f45cf34544990 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-08T19:49:21Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-6f37c1d44b404b15b17f45cf345449902023-12-24T12:10:40ZengBMCBMC Infectious Diseases1471-23342023-12-012311910.1186/s12879-023-08887-5Clinical effects of bacteremia in sepsis patients with community-acquired pneumoniaTae Wan Kim0Se-Uk Lee1Boram Park2Kyeongman Jeon3Sunghoon Park4Gee Young Suh5Dong Kyu Oh6Soo Yeon Lee7Mi Hyeon Park8Haein Lee9Chae-man Lim10Ryoung-Eun Ko11Korean Sepsis Alliance (KSA) investigators12Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineBiomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical CenterDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart HospitalDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineKorean Society of Critical Care MedicineAbstract Background Data regarding the clinical effects of bacteremia on severe community-acquired pneumonia (CAP) are limited. Thus, we investigated clinical characteristics and outcomes of severe CAP patients with bacteremia compared with those of subjects without bacteremia. In addition, we evaluated clinical factors associated with bacteremia at the time of sepsis awareness. Methods We enrolled sepsis patients diagnosed with CAP at emergency departments (EDs) from an ongoing nationwide multicenter observational registry, the Korean Sepsis Alliance, between September 2019 and December 2020. For evaluation of clinical factors associated with bacteremia, we divided eligible patients into bacteremia and non-bacteremia groups, and logistic regression analysis was performed using the clinical characteristics at the time of sepsis awareness. Result During the study period, 1,510 (47.9%) sepsis patients were caused by CAP, and bacteremia was identified in 212 (14.0%) patients. Septic shock occurred more frequently in the bacteremia group than in the non-bacteremia group (27.4% vs. 14.8%; p < 0.001). In multivariable analysis, hematologic malignancies and septic shock were associated with an increased risk of bacteremia. However, chronic lung disease was associated with a decreased risk of bacteremia. Hospital mortality was significantly higher in the bacteremia group than in the non-bacteremia group (27.3% vs. 40.6%, p < 0.001). The most prevalent pathogen in blood culture was Klebsiella pneumoniae followed by Escherichia coli in gram-negative pathogens. Conclusion The incidence of bacteremia in severe CAP was low at 14.0%, but the occurrence of bacteremia was associated with increased hospital mortality. In severe CAP, hematologic malignancies and septic shock were associated with an increased risk of bacteremia.https://doi.org/10.1186/s12879-023-08887-5BacteremiaPneumoniaCommunity-acquired infectionBlood cultureMulticenter study |
| spellingShingle | Tae Wan Kim Se-Uk Lee Boram Park Kyeongman Jeon Sunghoon Park Gee Young Suh Dong Kyu Oh Soo Yeon Lee Mi Hyeon Park Haein Lee Chae-man Lim Ryoung-Eun Ko Korean Sepsis Alliance (KSA) investigators Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia BMC Infectious Diseases Bacteremia Pneumonia Community-acquired infection Blood culture Multicenter study |
| title | Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia |
| title_full | Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia |
| title_fullStr | Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia |
| title_full_unstemmed | Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia |
| title_short | Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia |
| title_sort | clinical effects of bacteremia in sepsis patients with community acquired pneumonia |
| topic | Bacteremia Pneumonia Community-acquired infection Blood culture Multicenter study |
| url | https://doi.org/10.1186/s12879-023-08887-5 |
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